What Should I Eat Part 4

So in the spirit of our continuing discussion about the question what should I eat? It's a big question, isn't it? With a big question mark, I'd like to offer another step in our chapter four in this understanding. And this has to do with the concept of fruit and vegetables. So I think it's very obvious that the consumption of fruit and vegetables are desirable. We've seen that, you know, seen in many, many different studies, epidemiological studies, and even in a variety of intervention trials and different animal mod. The question really is how effective and what type of fruits and vegetables and what are the outcome variables it would expect? And when we rank this, would this be considered an important feature or just like one of those nice to have but not should have or have to have type of decisions. So would a study that has 512,891 adults in it be considered adequately powered to kind of address that question? Probably so. This is a pretty large study. This was actually done, as you probably know, in China. 10 diverse localities actually in China between 2004 and 2008. These were individuals from 30 to 79 years of age. And over the course of the year studied, they had 5,173 deaths from cardiovascular disease, 2,551 incident major coronary events, 14,759 ischemic strokes. And they recorded these among the 451,665 patients who did not have a history of cardiovascular disease. So these were kind of maybe the unexpected or the people that you wouldn't have necessarily triggered as a high risk population. So what did they learn? Well, they learned when doing stratified analysis that those individuals who consumed the lowest quintile of fruits and vegetables, particularly in this case fruit consumption, had a very significantly increased incidence of these particular non fatal and fatal conditions. Now, I want to emphasize that this was looking specifically at fruit consumption, not at vegetable consumption. That would be another part of the report that will appear later. But the fruit consumption part of it I think is very interesting. Remember, in China there's not a lot of frozen fruits and there's not a lot of other packaged fruits. So these are generally fresh fruits. So the question is, how many fruits do they have to eat and what was the relative impact that fruit consumption had across a wide range of different fruit types on these major disease indices? The interesting feature for me is that we often think of fruit as being just a load of fruit, various forms of simple carbohydrate, they're sweet. So we think, wow, that's going to contribute a sugar load. But in this case, as you may recall, if you eat the whole fruit, you get fiber, you get the vitamins, you get the minerals, you get the phytochemicals. So you get the whole complex of differing nutrients that are found in fruit. That kind of buttresses against then the worry about glycemic index because you're not eating a concentrated form of sugar, it is diluted by all these other factors in the whole fruit. And what they found was that there was a fairly strong regressional correlation between the amount of fruit consumption and the reduction in incidence of these major acute diseases. Therefore, I think we can come to the conclusion, at least in this Chinese population, across the range of fruit consumption as fresh fruit, that there is a very powerful protective effect that fruit consumption has on vascular diseases and diseases that are related potentially to altered vascular endothelial function and ultimately both cerebrovascular and cardiovascular accidents. Now, mechanistically, what do we know? Well, there's a whole variety of studies, as you probably know, that have tried to piece out or parse out exactly what are these characteristics of fruit that might impart these beneficial effects on human health. I think there's still a lot of room to go there. We've heard about antioxidants, we've heard about anti inflammatories, we've heard about influences that these phytochemicals have on reducing cell proliferation. So I don't think the full answ is in, But a variety of fruits from different seasons consumed fresh certainly has a very strong inverse relationship with that of cardiovascular and vascular cerebrovascular disease. So just another part of our what should I eat Story. I think it's the fruit consumption, particularly the fresh fruit throughout the course of the year. Looks like it's another important part of our overall dietary persuasions.